Episode Details

Cytokinetics (CYTK) Q2 2026 — Q2 2026 (3 months ended June 30, 2026): total revenue $28.6M vs a $17.6M bar, of which net product revenue $25.3M (US $23.0M, Europe $2.3M) - up from $4.8M in Q1. Loss per share $(1.50) vs a $(1.63) bar; net loss $198.8M. Total operating expenses $207.8M. The 8-K was accepted 4:11pm ET, AFTER the close, so Friday Aug 7 was the reaction session: $81.37 to $76.76, down 5.67% on 3,604,464 shares. Cytokinetics spent $7.26 of operating cost for every dollar of revenue it booked this quarter - $207.8M of expense against $28.6M of revenue - and almost every good thing in the release made that number worse. ACACIA-HCM hit both dual primary endpoints in non-obstructive HCM, and the company's response in the same press release was to raise 2026 spending guidance from $830-870M to $860-890M, in its own words 'prompted by the positive results from ACACIA-HCM.' The launch is working - product revenue 5.3x sequentially, over 700 prescribers, ~1,500 patients dispensed, over 80% on paid scripts, an 89.2% gross margin - and that is exactly what pushed SG&A ($104.4M) above R&D ($97.8M) for the second straight quarter. Shareholders paid the bill: 11,338,028 new shares at $71.00 for $760.1M net, taking the count from 122.6M to 139.0M in seven months. THE CALL: HOLD (3/5, FAIR VALUE $70 vs THE $76.76 CLOSE - 8.8% BELOW THE PRICE AND 36% BELOW WALL STREET) — base-case value ~$70.0 vs ~$76.76 today. KEY METRICS: - CALL: HOLD 3/5, fair value $70 vs the $76.76 Aug 7 close = 8.8% downside. Bull $130, bear $21. Buy under $60. Market cap $10.67B on 139.02M shares; EV $10.81B = 106x annualised product revenue of $101M. Breakeven needs $1.05B of product sales - 10.4x from here. - Street: Buy. 35 analysts, 34 buy / 1 hold / 0 sell, target $109.30 (range $84-$140), +42.4% vs the close. We are 36% below it. What to watch: UP: ACACIA-HCM met BOTH dual primary endpoints in non-obstructive HCM - the larger half of the disease, with no approved therapy anywhere; full data at ESC this month, sNDA in Q4 2026. Net product revenue 5.3x sequentially to $25.3M at an 89.2% gross margin, 700+ prescribers, ~1,500 patients dispensed, 80%+ on PAID scripts. $1.7B of cash plus a $175M undrawn tranche. 34 of 35 analysts rate it a Buy at $109.30. DOWN: $207.8M of operating cost against $28.6M of revenue - $7.26 spent per dollar sold. Spending guidance raised $30M BECAUSE the trial worked. 11.3M new shares at $71 took the count up 13.4% in seven months. Liabilities $2.10B on $1.92B of assets: book value is NEGATIVE $173.5M. Royalty Pharma owns up to 4.5% of worldwide aficamten sales ahead of you. And sales must rise 10.4x just to stop burning. Also on YouTube: @ChargedAlpha DISCLAIMER: For informational and educational purposes only. Not financial advice. Do your own research before any investment decision.